The goal of this project is to implement and evaluate an intensive, long-term case management program for a group of homeless chronic public inebriates who represent the most frequent users of the King County Detoxification Center. Ten case managers will be hired, each of whom will have a case load of about 15 clients. Subjects will be 120 Native American men, 120 mixed race (white, black, Hispanic and Asian) men, and 60 women. Within each subgroup, subjects will be randomly assigned to equal sized experimental (longterm intensive case management) and control (treatment as usual) conditions. All subjects will be interviewed, and have blood samples drawn for liver function tests, at admission and at 6 month follow-up periods for two years. Data will be analyzed to determine (a) whether intensive case management improves the clients' pattern of social service utilization, (b) whether intensive case management improves the clients' quality of life, (c) how the costs and cost-effectiveness of case management compares with treatment as usual, and (d) whether specific client or case manager characteristics are associated with successful outcome. Based on pilot study experience, we expect that case management will reduce alcohol consumption, reduce detoxification admissions, increase treatment service utilization, improve financial and residential stability, and improve family relations.